About: Utility of D-dimer for diagnosis of deep vein thrombosis in COVID-19 infection

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About: Utility of D-dimer for diagnosis of deep vein thrombosis in COVID-19 infection Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Utility of D-dimer for diagnosis of deep vein thrombosis in COVID-19 infection
Creator	Kim, Yuri Cho, S Hu, J Kim, Y Cheng, Olivia Cho, Edward Hu, James Ayala, Cheng, O D'ayala, Marcus Zenilman, Michael Marcus D'ayala, ; Mcclelland, P Mcclelland, Paul Zenilman, M
Source	Elsevier; Medline; PMC
abstract	OBJECTIVE: The objective of this study was to investigate the clinical utility of D-dimer in excluding a diagnosis of deep vein thrombosis (DVT) in patients with COVID-19 infection, potentially limiting the need for venous duplex ultrasonography (US). METHODS: We retrospectively reviewed consecutive patients admitted to our institution with confirmed COVID-19 status by PCR between March 1, 2020 and May 13, 2020 and selected those who underwent both D-dimer and venous duplex US. This cohort was divided into two groups, those with and without DVT based on duplex US. These groups were then compared to determine the value of D-dimer in establishing this diagnosis. RESULTS: A total of 1170 patients were admitted with COVID-19, of which 158 were selected as our study. Of the 158, there were 52 patients with DVT and 106 without DVT. There were no differences in gender, age, race, or ethnicity between groups. Diabetes and routine hemodialysis were less commonly seen in the group with DVT. Over 90% of patients in both groups received prophylactic anticoagulation, but the use of LMWH or subcutaneous heparin prophylaxis was not predictive of DVT. All patients had elevated acute-phase D-dimer levels using conventional criteria, and 154/158 (97.5%) had elevated levels with age-adjusted criteria (mean D-dimer 16,163 ± 5,395 ng/mL). Those with DVT had higher acute-phase D-dimer levels than those without DVT (median 13,602 [6,616-36,543 ng/mL] vs. 2,880 [1,030-9,126 ng/mL], p < 0.001). An optimal D-dimer cutoff of 6,494 ng/mL was determined to differentiate those with and without DVT (sensitivity 80.8%, specificity 68.9%, negative predictive value 88.0%). Wells DVT criteria was not found to be a significant predictor of DVT. Elevated D-dimer as defined by our optimal metric was a statistically significant predictor of DVT in both univariate and multivariable analyses when adjusting for other factors (OR 6.12, 95%CI [2.79-13.39], p <0.001). CONCLUSION: D-dimer levels are uniformly elevated in COVID-19 patients. While standard predictive criteria failed to predict DVT, our analysis showed a D-dimer of less than 6,494 ng/mL may exclude DVT, therefore potentially limiting the need for venous duplex ultrasonography.
has issue date	2020-07-30(xsd:dateTime)
bibo:doi	10.1016/j.jvsv.2020.07.009
bibo:pmid	32738407
has license	no-cc
sha1sum (hex)	a3883cb3713b259c5422cf78d4c2421cd93fcf45
schema:url	https://doi.org/10.1016/j.jvsv.2020.07.009
resource representing a document's title	Utility of D-dimer for diagnosis of deep vein thrombosis in COVID-19 infection
has PubMed Central identifier	PMC7390766
has PubMed identifier	32738407
schema:publication	J Vasc Surg Venous Lymphat Disord
resource representing a document's body	covid:a3883cb3713b259c5422cf78d4c2421cd93fcf45#body_text
is schema:about of	named entity 'COVID-19' named entity 'diagnosis' named entity 'infection' named entity 'COVID' named entity 'factor V Leiden' named entity 'D-dimer' named entity 'COVID' named entity 'DVT' named entity 'ascites' named entity 'pulmonary embolus' named entity 'D-dimer' named entity 'D-dimer' named entity 'COPD' named entity 'COVID-19' named entity 'parenteral' named entity 'multivariable analysis' named entity 'decontamination' named entity 'DVT' named entity 'institutional review' named entity 'D-dimer' named entity 'chi-square test' named entity 'acute kidney injury' named entity 'duplex ultrasonography' named entity 'cutoff values' named entity 'logistic regression' named entity 'COVID-19 pandemic' named entity 'COVID-19' named entity 'logistic regression' named entity 'DVT' named entity 'D-dimer' named entity 'DVT' named entity 'retrospective cohort study' named entity 'DVT' named entity 'D-dimer' named entity 'DVT' named entity 'DVT' named entity 'receiver operating characteristic' named entity 'prothrombin' named entity 'antithrombin III deficiency' named entity 'DVT' named entity 'diabetes mellitus' named entity 'programming language' named entity 'demographic factors' named entity 'Germany' named entity 'metastatic cancer' named entity '36,543' named entity 'retrospective cohort study' named entity 'contraindication' named entity 'univariate analysis' named entity 'retrospective study' named entity 'coagulopathy' named entity 'anticoagulation' named entity 'COVID-19' named entity 'DVT' named entity 'DVT' named entity 'sonographers' named entity 'D-dimer' named entity 'intubated' named entity 'thromboprophylaxis' named entity 'systemic inflammatory response syndrome' named entity 'DVT' named entity 'diagnostic tests' named entity 'DVT' named entity 'COVID' named entity 'dialysis' named entity 'D-dimer' named entity 'D-dimer'

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